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The selective mechanism that avoids systemic hormonal disruption suggests potential for extended use compared to interventions that create metabolic or endocrine imbalances requiring periodic breaks

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Indications include: Medically refractory disease not responding to optimized biologic therapy Bowel obstruction from fibrostenotic stricture Intra-abdominal abscess not amenable to percutaneous drainage Complex perianal fistula (seton placement, diversion) Enterocutaneous or enterovesical fistula Dysplasia or cancer in Crohns colitis Free perforation (rare) Nutritional Therapy Exclusive enteral nutrition (EEN) effective for induction in pediatric Crohns

Elevating Healthcare Professional Education A common problem faced by PA patients is the adherence to a rigid, infrequent injection schedule (typically 1mg every 2-3 months)

Therapeutic Rationale Behind the Standard Dose The 1000 mcg dose is chosen for its quick fix of vitamin B12